Sam R. Hall: Governor wrong about exchange, and he knows it

Sep. 28, 2013

Written by

Sam Hall

When Gov. Phil Bryant and Insurance Commissioner Mike Chaney were going toe-to-toe over whether the state or the federal government should run a health care exchange, the hope of Bryant and several other Republican governors was that forcing the federal government to run the exchange would contribute to the downfall of Obamacare before the law was ever implemented.

These same governors were betting on Congressional Republicans to force the defunding of the law and therefore making any debate over an Obamacare-related health care exchange moot.

It is therefore ironic that we are now two days from the launch of the exchanges, and the idea of defunding Obamacare is what is threatening a government shutdown and possibly the United States defaulting on its loans.

During an editorial board meeting last week, Chaney was clearly still smarting a bit from the fight with Bryant. It’s not that Chaney is sore about losing — though he definitely is someone who despises losing — but that there was ever a fight in the first place.

The similarities between the battle over a state-run health care exchange in Mississippi and the current battle over defunding Obamacare in the face of a government shutdown are many.

Bryant opposed a state-run exchange because he said it would lead to more federal control over Mississippi’s health care system and because it would provide an avenue for the federal government to expand Medicaid. However, the realities show Bryant was wrong.

Under the state-run exchange Chaney proposed, the federal government would have paid 98 percent of premium costs for people making between 100 percent and 138 percent of the poverty line.

Chaney said the state could have put 50,000 additional people on the exchange and paid for the remaining 2 percent of the premiums without expanding Medicaid.

Instead, many of these people will likely not get insurance because paying a $95 fine is more affordable than paying among the highest premium rates in the nation for health insurance. That means they will continue to seek health care at hospitals, and the cost of indigent care will continue to be unaffordable for those hospitals.

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Expanding Medicaid will be far more affordable in the long run, but it will be far more expensive than Chaney’s plan of using a state-run exchange.

Then there is the unexplainable idea that a state-run exchange somehow would allow for more federal intrusion than one actually run by the federal government. Chaney can barely keep a straight face when asked about this argument, and who can blame him? It makes no sense.

Chaney said that he has authority over only the rates charged and the coverage plans submitted by insurance companies participating in the exchange. Everything else is controlled by the federal government.

Under the exchange launching Tuesday, the federal government has trained “navigators” to help people purchase health insurance. These “navigators” don’t have to have any previous background in insurance. They have received training, but they are not licensed insurance brokers or agents.

“I wanted to keep agents and brokers involved,” Chaney said of his proposal, “because I can get on them pretty hard if they get out of line. I can’t do that with navigators.”

In other words, no state-level control over the “navigators” exists.

Chaney has no appetite for the current political climate.

He opposed Obamacare, but he has sworn to uphold the laws of the land in a way that’s best for Mississippi. When it comes to Obamacare and Mississippi, that would have been the state-run exchange Bryant blocked.